HEALTHY CITIES ILLAWARRA Ten Years On 1987 - 1997 Author Dr Pat Mowbray with contributions from Tony Mills Penny Lumb Linda Brazier Katherine van Weerdenburg Healthy Cities Illawarra Inc. is funded by the NSW Department of Health and the Illawarra Area Health Service HEALTHY CITIES ILLAWARRA Ten Years On 1987 - 1997 Contents Page Acknowledgement .. .. .. .. .. .. .. .. .. 1 Introduction .. .. .. .. .. .. .. .. .. .. 2 A Case Study of the Illawarra .. .. .. .. .. .. .. .. 8 The First Three Years .. .. .. .. .. .. .. .. 10 The Process and Reality of Community Development .. .. .. .. .. 13 Working with Disadvantaged Communities .. .. .. .. .. .. 16 Task Forces .. .. .. .. .. .. .. .. .. .. 22 Spreading the Message across Australia and Overseas .. .. .. .. 30 Working with Key Organisations .. .. .. .. .. .. .. 32 Healthy Cities Shoalhaven .. .. .. .. .. .. .. .. 36 Supporting Communities since 1990 .. .. .. .. .. .. .. 44 Needs Assessments and Evaluations 1991-1996 .. .. .. .. .. 50 Working in Partnership - Healthy Cities Illawarra and the Illawarra Safe Communities Program .. .. .. .. .. .. 53 Conclusion .. .. .. .. .. .. .. .. .. .. 58 Management Committee and Staff .. .. .. .. .. .. .. 59 Acknowledgements The Healthy Cities concept is based upon collaboration and partnerships between various sectors. Healthy Cities Illawarra necessarily has a long list of partners and supporters who have co-operated and contributed to the past ten years achievements. The following people and organisations have all been integral to the development and success of Healthy Cities Illawarra: • NSW Health Department • Illawarra Area Health Service - Health Promotion Unit Illawarra Public Health Unit Board, management and staff Community Health Services • Local government councils of Wollongong, Shellharbour, Kiama and Shoalhaven • State and Federal Members of Parliament • Local media • Commonwealth Department of Health and Family Services • Roads and Traffic Authority • World Health Organisation • Other businesses, service providers and sponsors who have supported various projects. A special acknowledgement to the backbone of the organisation - those volunteers who have served on the Management Committee, Council of Reference and Task Forces over the years. Also to the past and current staff who have given beyond the call of duty because they believe there is a better way. Thank you all. Healthy Cities Illawarra Incorporated 49 Kembla Street, Wollongong, NSW , Australia 2500 Phone: 02 42265000 Fax: 02 42265339 International + 61 Internet: http://www.healthycitiesill.org.au HEALTHY CITIES ILLAWARRA Ten Years On Introduction In early 1987, the Australian Community Health Association with funding from the Commonwealth Department of Community Services and Health sponsored a three year Healthy Cities pilot project. This was the result of members from both organisations attending conferences in Europe, North America and Canada organised by the World Health Organisation (WHO). These conferences reflected the growing concern regarding the health of the planet and its peoples and the necessity for all to work together to achieve Health For All. This concern was expressed in a commitment to primary health care as far back as 1978 at Alma Ata and the identification of Health For All targets from 1980-84. It culminated in the development of the Ottawa Charter for Health Promotion in 1986 out of which the Healthy City movement was born. It was designed to implement the Charter at a local level. The Illawarra region together with Canberra (ACT) and Noarlunga (SA) was fortunate to successfully submit for one of the three $60,000 each available grants. Illawarra is on the south coast of New South Wales. It was chosen because of the mix of urban to rural population, its heavy industrial base, high ethnic population, high unemployment and low average income and because of the growing partnership between the recently established Illawarra Area Health Service and the University of Wollongong. It is also an area of great natural beauty. Initially the project involved the three local governments of Wollongong, Shellharbour and Kiama (combined population 230,000) but has since included the Shoalhaven (population 70,000). Thus the Illawarra became part of the Australian Healthy Cities movement. As it was established shortly after the initiation of the movement in Europe, there was a sense of the unknown and very much a "flying by the seat of your pants attitude". While we now know a lot more about how to establish and support a Healthy City, Community, Town, Village or Island, I still believe that something of this pioneering spirit and willingness to take risks is essential to the success of individual Healthy Cities projects, as each project differs in its approach and priorities, sometimes enormously so. There are now some 2,000 Healthy Cities, Communities, Towns, Villages and Islands throughout the world. The movement is still growing rapidly, particularly after the establishment of a Healthy Cities office in every regional centre of the WHO. This past twelve months we have welcomed five new Healthy Cities in NSW - Albury-Wodonga, Temora, Port Macquarie, Healthy Villages Blue Mountains and Hawkesbury-Windsor. It has also seen the establishment of the NSW Healthy Cities Liaison Group formed in conjunction with the WHO Regional Training and Development Centre at the University of NSW. There has been a growing awareness of the increasing threat to the world environment and the necessity to harness the community and the economy to ensure that the way forward is supportive of health rather than leading to its ongoing deterioration. At a local level, work has commenced with Kiama Council with a Municipal Health Plan in a visionary and strategic planning process, to bring together the environment, economy and the community for better health and a better environment. At a global level, Healthy Cities Illawarra is one of the initiators of the Global Ecohealth Network (www.vianet.net.au/ eco-heal). The Network aims to bring together individuals and organisations who are concerned about and want to tackle the worldwide threat to public health caused by the deteriorating world environment. The next ten years will be crucial to the future health of the human race. HEALTHY CITIES ILLAWARRA CHARTER 1. Every individual has an equal right to his or her optimum level of health. 2. Health is the responsibility of everyone in the community. 3. We therefore commit ourselves to action at a local level to improve the health of the people of the Illawarra by: • Working together on a co-operative basis • Supporting community action • Developing personal skills and worth • Ensuring effective health advocacy • Encouraging health promotion and community care • Protecting and enhancing the physical environment • Recognising the right of the individual to work and contribute • Developing local policy and actions to establish a social, economic and physical environment conducive to health. AIMS 1. To involve government agencies and non-government organisations in the development of Healthy Public Policy and actions by acting as a catalyst for change. 2. To increase community awareness at every level of the many factors which affect health and the necessary elements of a Healthy City. 3. To achieve wide community involvement through intersectoral collaboration and community participation recognising the special needs of those most disadvantaged. 4. To act as a community advocate and facilitate supportive community action. 5. To assist in the re-orientation of services towards community need. 6. To facilitate the creation of a social, economic and physical environment in the Illawarra which is supportive to health. 7. To develop links and a mutually supportive relationship with participating Healthy Cities and new and intending Healthy Cities. Guiding Principles Four Beacons The mirror of "Health for All" is "All for Health". The path to achieving this aim is thorny but rewarding, full of minefields but also full of surprises. In Australia there is a tendency to label community organisations full of "good" people doing good things as opposed to more formal bureaucratic organisations which are labelled "bad" people doing bad things. Yet there are positive and negative forces in every organisation and indeed in every individual. How then do we proceed, when our brief is to work with people and organisations at every level, some of whom may be diametrically opposed to each other or whose ele ments seem to negate our task? This process can never be an easy one. Four beacons have guided us on our way. (1) The Ottawa Charter (1) • Build Healthy Public Policy • Support Community Action • Develop Personal Skills • Create Supportive Environments • Re-orientate services (not just health services we believe) towards community need. This charter outlines a total approach which Healthy Cities was designed to implement at a local level. It acts as a constant monitor of progress. It automatically means that one must grapple with all the difficult factors outlined previously. However it also acts as an inspiration in its totality. In working with the Ottawa Charter one becomes aware of the connections between the five elements - wherever one starts one is drawn inescapably into the other four. In fact we see the five elements as together constituting true community development. Thus we feel everyone has a role and responsibility in the process - not only the grass roots, but every person at every level. (2)